This information is intended as a general guide only. Please ask if you have any questions relating to this information.
What are thread veins?
Thread veins (‘spider’ or ‘reticular’ veins) are extremely common and are usually left untreated due to constraints on the NHS. Most thread veins cause no symptoms apart from minor aching or throbbing but the cosmetic appearance may be a considerable cause of distress.
What treatments are available?
It is important to treat any underlying varicose veins before considering treatment of thread veins. This will be part of the full clinical assessment before deciding on the correct treatment. It should also be noted that no treatment for thread veins can be guaranteed to be 100% effective; the aim is to improve the cosmetic appearance. Thread veins are harmless and do not need treatment. It is very unusual for the veins to cause symptoms and even if there are symptoms in the area of the veins, treatment may not help. Treatment is therefore usually cosmetic.
Thread veins can be treated using laser or injections. As a general rule, laser treatments are better for facial veins and injection works better for leg veins. The sclerosant that we use is called Sodium Tetradecyl Sulphate (STS, ‘Fibrovein’) which has been used for injecting veins since the 1940s.
What is Microsclerotherapy?
Sclerotherapy involves injecting a solution (sclerosant) into the thread veins which causes damage to the cells that line the vein causing it firstly to clot and then to form scar tissue (sclerosis).
No local anaesthetic is needed as the needle is tiny (less than 0.5 mm). The skin is cleaned with an alcohol wipe and the needle placed in the thread vein. A small volume of the sclerosant solution is injected and the needle removed. Multiple injections are usually needed. These injections are associated with a mild burning and tingling feeling over the injected vein.
Once the vein is injected it becomes inflamed. The vein and the area around become red and raised and appear not dissimilar to an insect bite. The redness quickly settles and a mark is left in the skin along the length of the vein. This mark varies in colour from black to brown to green. This mark is the closed vein. Your body then reabsorbs the closed vein.
After the procedure
Immediately following the procedure a band aid will be applied and a compression stocking will be fitted to your leg and you can return to work later the same day.
Once your compression stocking is applied, you will be required to go for a brisk 15 minute walk and then twice daily for 2 weeks.
The compression stockings helps seal the treated veins, minimizes trapped blood and pigmentation, reduces the number of treatments necessary and reduces recurring varicose veins.
The bandaid and the compression stocking should be left undisturbed for 2 days (48 hours) after which they should be removed and then you are able to bath/shower. The stocking should then be worn during the day only for a further 2 weeks (ie you can take it off over night and for bathing). Should the compression stocking get damp either gently pat it dry or use a hair dryer to dry it. Sunbathing should ideally be avoided for 4 weeks.
You can return to work later the same day but avoid hard physical activity (aerobics and weight lifting) for the first 48 hours.
When will the vein have disappeared?
This varies from person to person and from vein to vein. As a general rule the older the patient, and the bluer the vein the longer it takes. After the treatment the area looks worse for a period of time and then gradually improves. Usually by 4 months there is often still some residual staining but people are happy that it looks better. In some people however the residual brown staining can take many months (up to 2 years) for the final appearance and in about 10 – 15% some residual skin staining will persist.
It may take 2 – 4 treatments to obtain a satisfactory result.
Complications
Inflammation of the vein from the sclerosant (phlebitis) is a common complication. The main risk from sclerotherapy is brown pigmentation over the site of treatment (10 - 15% risk) although this is minimised by reducing the concentration of the sclerosant when treating smaller veins. Matting (formation of tiny red veins) may also occur in 1 to 10% of cases and of course new thread veins can develop at other sites. Rarer risks (less than 1:1000 cases) include a small ulcer over the injection site, deep vein thrombosis and an allergic reaction.
You must bring the compression stocking back to your next appointment or any further procedures will not go ahead.
Further information
External links.
